Provider Demographics
NPI:1902850100
Name:AGACANYAN, ARMEN B (DC)
Entity Type:Individual
Prefix:DR
First Name:ARMEN
Middle Name:B
Last Name:AGACANYAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18525 SUTTER BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-2899
Mailing Address - Country:US
Mailing Address - Phone:408-779-3565
Mailing Address - Fax:408-779-9810
Practice Address - Street 1:18525 SUTTER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-2899
Practice Address - Country:US
Practice Address - Phone:408-779-3565
Practice Address - Fax:408-779-9810
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29204111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor